New PEPFAR Legislation Will Help Train 140,000 Health Care Workers

The US Senate voted Wednesday night to reauthorize PEPFAR –
the President's Emergency Plan for AIDS Relief. But in doing so, it also
boosted spending to $48 billion over five years. That's up from $15 billion. What's more, it lifts the travel ban
on those who are HIV positive, who want to come to the United States; and it
supports efforts to overcome the healthcare worker shortage.

The legislation now goes back to the House of
Representatives where members will consider the senate revisions.

Among
those praising the reauthorization of PEPFAR is John Bradshaw, Washington
director for Physicians for Human Rights. He spoke to VOA English to Africa
Service reporter Joe De Capua about the effects of the updated legislation.

"The
first thing this will do is send a real message to people in Africa and
elsewhere, who have been benefiting from PEPFAR programs, that the United
States has renewed and reenergized our commitment to battling AIDS,
tuberculosis and malaria. So, there's an important symbolic signal being sent,"
he says.

The
legislation has dramatically raised the amount of money that would be spent.
"The bill authorized $48 billion…we still have to get through the
appropriations process and get that money out there. So there will be some
delay before it actually has a direct impact on the ground," he says.

It
may be sometime next year before the legislation is finalized. In the meantime,
funding would continue at current levels.

Bradshaw
says the latest version of PEPFAR reflects lessons learned in the first five
years. "One really important lesson was that we can't really get our hands
around the AIDS epidemic unless we increase the number of health care
professionals in Africa and paraprofessionals. So this is one of the really
important new innovations in this bill compared to the original PEPFAR. There's
a target of training and retaining 140,000 new health care professionals and
paraprofessionals. And that's really the largest or the most significant
commitment any developed nation has ever made to tackle that problem," he says.

He
says that PEPFAR also addresses the issue of women's particular vulnerability
to AIDS. "You have to have programs to empower women and to help them address
some of these legal and social obstacles that prevent them from getting proper
care, and also make them more vulnerable to infection," he says.

During
PEPFAR's first five years, there was much debate and controversy over whether
it emphasized abstinence over condom use. Bradshaw says there was no such
public controversy this time. "The controversy was minimized. I think there was
a lot of important work behind the scenes with congressional staff and members
along with the human rights and ngo community to try to avoid the really most
contentious issues. But the so-called abstinence earmark that mandated that one
third of all prevention funding go to abstinence-only programs has been
eliminated, which we think is a big step forward," he says.

Bradshaw
says a comprehensive approach is needed to address HIV/AIDS. "The programs that
focus only on abstinence have been shown to be not as effective as these
comprehensive, evidence-based programs," he says. Some abstinence programs will
remain, however.

He
also praises a provision in the legislation lifting the 20-year-old travel ban
on those who are HIV positive and want to come to the United States. He says,
"This is a great victory that's contained in this bill… There was never any
justification for this travel ban… There was no public health justification."

The US Department of Health and Human
Services would take over authority of deciding if anyone was a health risk if
he or she entered the country. The travel ban has been part of immigration
policy.